ADENOID (ACANTHOLYTIC) SQUAMOUS-CELL CARCINOMA OF THE SKIN
ADENOID (ACANTHOLYTIC) SQUAMOUS-CELL CARCINOMA OF THE SKIN
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DOI：
10.1111/j.1600-0560.1989.tb00024.x
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发表时间：
1989-06-01
影响因子：
1.7
通讯作者：
WICK, MR
中科院分区：
文献类型：
--
作者：
NAPPI, O;PETTINATO, G;WICK, MR
皮肤腺样鳞癌(ASCC)是一种以肿瘤细胞棘层松解为特征的肿瘤。由于这种病变有时在诊断上可能很麻烦，我们研究了55例患者的临床、组织学和免疫组织化学特征，以进一步阐明其特征。ASCC多见于老年患者的头颈部皮肤。在这一系列的49名患者中，46名男性和3名女性；他们的确诊年龄从25岁到90岁不等，平均71岁。6例患者有2个异时性肿瘤。ASCC通常表现为懒惰，尽管19%的病例确实广泛转移并被证明是致命的。肿瘤大小大于1.5厘米似乎与不良临床结局的风险相关。此外，10名皮肤ASCC患者随后发展为内脏恶性肿瘤。皮肤肿瘤的典型特征是真皮内呈侵袭性、管状或假腺体状的多角形细胞，胞浆呈玻璃样嗜酸性，并有局限性鳞状珍珠形成。覆盖的表皮的连接通常是明显的。免疫组织化学显示ASCC对细胞角蛋白反应均匀，但缺乏特化腺体细胞的标记。这些发现否定了这种肿瘤表现为部分附件分化的解释，并表明免疫组织学可能有助于ASCC和皮肤原发或转移性腺癌的鉴别诊断。
Cutaneous adenoid squamous carcinoma (ASCC) is a distinctive neoplasm featuring tumor cell acantholysis. Because this lesion occasionally may prove troublesome diagnostically, we studied the clinical, histologic, and immunohistochemical features of 55 examples in order to further elucidate its characteristics. ASCC most often occurred in the skin of the head and neck in elderly patients. Of 49 patients in this series, 46 were men and 3 were women; their ages at diagnosis ranged from 25 to 90 yr, with a mean of 71. Six individuals had 2 metachronous neoplasms. ASCC generally behaved in an indolent manner, although 19% of cases did metastasize widely and prove fatal. Tumor size of greater than 1.5 cm appeared to correlate with the risk of an adverse clinical outcome. In addition, 10 patients with ASCC of the skin subsequently developed visceral malignancies. The cutaneous neoplasms were typified by invasive, tubular or pseudoglandular profiles of polygonal cells in the dermis, with glassy eosinophilic cytoplasm and focal squamous pearl formation. Connections of the overlying epidermis were commonly apparent. Immunohistochemically, ASCC demonstrated uniform reactivity for cytokeratin, but lacked markers of specialized glandular cells. These findings militate against the interpretation that such tumors demonstrate partial adnexal differentiation, and show that immunohistology may prove helpful in the differential diagnosis between ASCC and primary or metastatic adenocarcinomas of the skin.